A warm scarf or turtleneck-style neck-warmer that covers over the nose and mouth keeps the air a child breathes warm enough to ward off cold temperature-related asthma symptoms.

Winter usually ushers in plenty of exciting outdoor activities for kids, like sledding and snowball fights. It’s a lot of fun, but the chilly air can be tough on kids with asthma.

“The cold, dry air of winter can really irritate a child’s asthma,” says Amy Burack, RN, MA, AE-C, program manager of Children’s Hospital Boston’s Community Asthma Programs, a division of the hospital’s Community Asthma Initiative (CAI).

And when asthma symptoms flair, it leads to more than discomfort. For many children, it can lead to a trip to the Emergency Department or worse, hospitalization. Asthma continues to be the leading admitting diagnosis at Children’s Hospital Boston.

To counteract those numbers Burack and her colleagues at the CAI have worked hard with families in local communities to help educate people about how to better manage their kids’ asthma. In five years the Initiative has successfully contributed to cost savings by reducing Emergency Department visits and hospitalizations and improved quality of life through a reduction in lost school days for children and missed work days for caregivers.

Amy Burack, RN,AE-C

A cornerstone of the CAI’s education efforts emphasizes that living with asthma doesn’t mean a child can’t enjoy having fun outside, even during the winter months. In fact, with just a little extra and strategically placed clothing, most kids with asthma are just fine playing in the cold air. A warm scarf or turtleneck-style neck-warmer, placed over the nose and mouth, insulates the air a child breathes and keeps it warm and humid enough to ward off most cold temperature-related asthma symptoms.

“When cold air hits the lungs it can cause the muscles around the airways to contract, which complicates breathing in many kids with asthma,” Burack says. “But that little extra barrier of cotton or fleece over the nose and mouth is usually enough to prevent a bronchial spasm. It’s easy and works quite well.”

But once the kids come in from the cold, the warm inside air can prove difficult for some young asthmatics as well. Home heating systems often produce very dry air that can trigger breathing problems.

To counteract this dryness, Burack recommends the use of saline nasal spray to help keep nasal passages well moisturized (make sure you check with the child’s doctor first), and using a room humidifier to add moisture to the air. Humidifiers can do wonders for taking the dry sting out of the air, but if you are going to use one it’s important you remember to clean it regularly and replace the water daily to avoid mold and mildew from developing.

If you can’t afford a humidifier, it’s perfectly acceptable to fill a big pot with water and leave it on top of the radiator or near a heating vent. As long as its not in danger of tipping over or becoming a tripping or electrical hazard, the pot method is a safe, inexpensive way to add some much needed moisture to a room. “When money gets tight, like it is for so many families these days, a little ingenuity can go a long way,” Burack says.

Making your house as asthma friendly as possible is a good start, but preventative asthma management isn’t just for home. When your young asthma patient heads off to school or daycare this winter, make sure he’s had his flu shot, because even the most well controlled child with asthma will experience some breathing difficulty if he gets sick. It’ also important to make sure every adult caring for your children has a written copy of their asthma management plan, access to a current prescription of their quick relief medication and the appropriate delivery device, which is usually a spacer or nebulizer machine.

Exposure to cigarette smoke is extremely problematic for children with asthma, especially in the winter when people are less likely to smoke outside or open windows for better ventilation. Fortunately for residents in Boston public housing, a new law banning smoking inside all public housing will take affect in 2012, which should greatly reduce the number of asthma attacks caused by smoke in those buildings.

“Cigarette smoke travels- walls and doors don’t really phase it,” Burack says. “Smoke-free public housing will significantly improve the lives of people living there who are also dealing with asthma.”

How you manage your child’s asthma may differ with the season, but the underlying fact that kids with the condition can enjoy all of the same activities as their peers doesn’t change. As long as you are prepared, winter asthma is manageable and shouldn’t’ interfere with your family’s ability to enjoy the season.

“Having asthma is all about management and control,” Burack says. “Some of the best athletes in the world are severe asthmatics, they just have learned how to control their asthma so it in turn doesn’t control them, which most families can do as well.”

The Community Asthma Initiative at Children’s Hospital Boston works with children and their families to help manage their asthma in their own home. The program covers a full range of care: prevention, evaluation, treatment, parental support, case management, training and education and policy advocacy. The program’s goal is to engage the entire community, including families, schools, community health centers, advocacy groups and community-based organizations. Learn if the Community Asthma Initiative can help you and your family.

Keeping the home asthma friendly is so important. We’ve made just a few simple changes and it’s made a big difference. We’ve done the humidifier and all that, but what’s made the biggest difference is having the air quality in the home cleaned. Especially in the winter when circulation isn’t as good, having the air quality cleaned up can make a big difference. We found a good company that does this kind of stuff. They’re called Decon Pro Green, you can google them.